YouSaid · the spoken record
Gregory Adams
- lines on the record
- 54
- first
- 2018-12-21
- most recent
- 2018-12-21
- sittings or episodes
- 1
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- podcast
Every line below is reproduced as it was said and linked to the record it came from. Nothing here is summarised or generated. Directory · Search · Corrections
“The real serious issues of mental health, suicide, we're doing massive studies on suicide to figure out are there additional things that we can do in the prevention aspect of suicides? I mean, you probably know this. Unfortunately, over 50% of individuals who commit suicide shows no real sign of it. Before it happens, right? I mean, that is just mind-blowing to.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“I think that we are seeing the beginnings of a shift in the governments around the country, state level governments, the nation, and some of the issues that we've been talking about. We are hearing much more from employers who's dealing with workplace issues of stress management and absenteeism and all those kind of issues. And we are embracing that with them and saying let's work together on figuring out what we can do about this in the worksite and on the workplaces and those kind of things. I think the last area is most importantly as our members become more bold in being willing to talk about their life experiences. More powerful than the storytelling that goes along with that, where people are willing to become more open and say, look, this is what I'm dealing with and here's the help that I can get. And then you have the...”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“You know, actually, the good news is one of the things that we have. Done is we've been very vocal. We've spent money on advertising. We talk about it, we invest in it, and then we open our doors for others to come in and take a look at it.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“Some of the other issues that are going on with you because maybe there's some additional things that we can help you with and you begin that kind of a dialogue, which is much more of our model, right? So right now, one of the beauties of our model, you can come in and see your primary care physician, something that's going on with your knee, she can say, look, I have Dr. Smith down the hall. He's an orthopedic doctor here. He can come in and look at this. He could tell you right away what's going on. Would you like him to come in? Absolutely, right? Look, I noticed you're not sleeping at night based on what you're telling me. I have a behavior health.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“How do you think both of it? We did a study in one of our regions and did this for a long period of time and discovered that about 30 plus percent of the members, patients who were coming in for an appointment, when you began to drill down into the questioning about 30-something percent of those visits in this study was really based on a mental health issue, right? So the person may have called in to say, look, I need to come in because I'm suffering from back pain and I can't take it anymore. Then in the questioning of how are you sleeping, not well. How many hours are you sleep at night? Maybe two if I'm lucky. Is everything going on in the family? No, really, I'm dealing, you know, all those things that leads to a warm handoff in having somebody to come in and say, let's talk about.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“And so, what we're doing now is redesigning our care delivery where we're integrating mental health directly into primary care, for example. We are creating different tools for how people who are dealing with anxiety and other issues who are not sick enough that they need to be hospitalized and or inside of the delivery system, but they need an extension of who I can talk to when I need to deal with the fact that at 2 o'clock in the morning, I'm now very tense about what I'm about to go into for the next day or week or month. And so we have been redesigning the whole mental health protocols or physicians and others that integrate now mental health into the practice of medicine like everything else.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“Hard to tell. Exactly. It's hard to tell, but depending on the way you're defining it, it can go upwards of 25% of the total population when you talk about it should be in treatment or other things to 50-75% when you add things like everyday stress and stress, anxiety and all the other stuff that we see as a common practice.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“We're going to force the industry to come to terms with number one, the brain is an organ like any other parts of the body. And so now we're very comfortable talking about heart disease. We ought to be as comfortable talking about something that's going on in the brain. The second thing we said was, look, we needed to help lead the parade in how to destigmatize mental health and how to talk about it in a way that people can relate. Because guess what? mental health challenges are in all of our families is in our neighborhoods it's in our churches it's in our communities it's something that the majority of people are dealing with in one form or the another”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“Mental institution. Mental institutions. And we separated the records from the general records and we put extra laws around it to protect them so the world didn't know they had a mental problem. And the work that we're doing is to say, no, we're actually now reattaching a head to the rest of the body.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah. I talk a lot about that one of the things that we did in the industry and in society is we detached the head from the body. And we over time, we built a culture around mental health as a bad thing. Right, and so we had all kinds of negative names for it. We called people bad things that they were nuts and stupid and all that stuff. We built a whole medical system as an industry where they went through a special door.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“And so, if we can enhance the entire industry, then we're serving the bigger purpose, which is what we believe we're here for as well. Is not just the members that we have the privilege of taking care of, we also have a responsibility to the entire community.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“We share it because number one Predominantly we're a not for profit organization. We're 501. We get great benefits from that. Number two, we think two things. One, if we stay sharper in strategy, we've turned the corner before our competitors. And if we stay clean on execution, they cannot catch us. At least that's our mental working model, right? We're working on right now. We have some of our competitors that are trying to replicate our model. And if you came inside of Kaza Permanente, you hear her say something like, and when they knock at the door to tell us that we're here, Will be gone It's energizing Because it's not based on, I'm trying to hide something from you. It's based on, we just want to keep getting better.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“And what's your philosophy in terms of competitive advantage versus being open and advancing the world in terms of your data set and then your findings from that data set? Like, do you keep that all to Kaiser? Do you share that? Or how do you think about that?”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“Well, right now, on average, about 18 years. So, I mean, we can even calculate, and this is before AI, we can calculate that if a new member drawing kind of permanente. If we do all the things right in the first couple of years, we can predict now, forecast how long they will stay with us. Very important in our model and in our value proposition because we invest a lot in all of our new members to understand what's going on with their bodies, to deal with the medication changes. And so there's a lot of prep work up front, but it pays off with their health, with their well-being, and with the efficiencies of care.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, I mean, our physicians in the Permanent Medical Group, I mean, we have the, we've always done the research, and we've always used the data for the benefit of our members in patient care and all that. We have added sensitivity today because everybody is even more concerned about making sure that we're not misusing their data. And making sure that we're not using it in ways they didn't authorize us to use it. We're very sensitive to that. That being said, yes, we are becoming much more aggressive in the use of the data to better understand many of the things that you are talking about. And the other benefit of our system is we have all the data. Is great longitudinal data because our members stay with us much longer than any one of my competitors.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“Smoking because we were very clear about what it was going to cost. Well, we're very clear that obesity caused many of the things that we're dealing with, right? But it's not as clean in terms of how do you address it in an aggressive way like smoking because it's much more complicated.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“And we've had many debates with well, is the fundamental opportunity here is to let the data lead to discovery? Or do you, you know, for me, that's like walking in the wilderness, right? Nothing negative about it. It's just not our approach. We're just trying to figure out how we take all of this incredible data that we have now. And how do we begin to use it to predict ahead? And so we should be at a stage now where we know enough and we have enough information that I can predict what would happen if you keep doing these three things or these four things. And I want to work on these four things. And in some ways, we've done that without all the wrappings of AI in our past. We figured out the importance of not smoking, right? And really took it on by any means necessary to try to prevent people.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“What are the areas that you're really driving? You're getting on. Tell them medicine no question. We just see tremendous opportunities in that direction. I think the AI is a big opportunity, but it has to be focused because many organizations right now are chasing the AI and not clear what they're trying to answer, right?”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“But what are the technologies that you think are imperative that you have to get to, that you're going to find a way, like whatever we do, we're going to get to whatever it is, understanding our data better or telemedicine or what are the areas that you're really driving.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“That's the problem I speak of, but one of my executives rightfully slow said, Well, I think we have to be careful on this third line item. Called strategic investment in technology because it feels like it's too much of the shiny corn or whatever coin or something. Know, and I was a little irritated with it because clearly it was an indirect message to me But his point was well taken. The point was let's not set ourselves up where we're going to have people chasing the shiny object His real point was Bernard, you're after efficiency and better outcomes for our members with the experience that's really focused on the investments in that direction. And we can go faster. And so there's that mindset out there, but it's hard for us. And we're getting much better at it”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“I think where you have incredible opportunities is that now as an industry, I think we have come to terms with we got to figure out how to leverage technology for the whole consumer experience. So that's just prime time. And Kaiser Permanente, for example. Before coming down here, I was on the team with my executive team all day. The majority of the time we were talking about technology. And there are a couple of people on my team. I have a speak up environment. My team gets to say whatever they want to say to me. It's based on the theory we live in a great country. You speak your mind, right?”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“I think where we're very excited now is that a lot of smart people are creating, and the final thing is, and you may not like hearing this, one of the things I'm talking about right now inside of Kaiser Permanente is I strategically don't support we're just innovating in a corner and I can't scale. So that's nice to have it in the corner. But I'm looking at the whole system. And so I want to pay for and promote innovation with technology with the sight of how can we scale it and leapfrog as a result of it as opposed to we have a thousand points of light and we have a thousand points of light. I think”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“And that's before you get to making the technology work. Right, then it's got to work. Slow progress. Get to that next stage. I would say that we're in a different place in Kaiser Permanente because we've been at it so long. And we don't feel like we go fast enough. I want to be clear. And so when we say we're going to implement something that Kaiser Permanente and we think is a very easy system to do, and then you get started and you start to learn that we have all these interfaces that we have to create and all this stuff. And because we're an integrated system, that's mission critical. It becomes a very delayed process for us.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“And we go home every night tired. No, I mean, the challenge we have in healthcare, there are a couple of things. One, as you and I started this, it's basically building technology on a fragmented system, right? And you and I both know that either that's going to be so dramatic that you just start from a blank sheet of paper. And that's very hard for us in the industry, right? Yes. The second thing is it's a strong culture. Working inside of the healthcare industry on one hand is beautiful because you're talking to and working with some of the most intelligent people on earth, I would argue. And so the intellect is very high and the ownership is deep. And so when you're introducing technology, there's a healthy dose of skepticism. And there's a fear of the change, right?”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“And then the third thing that we're working on right now is this whole issue, which is the worst of all things if you don't have a basic shelter over your head and you're going to bed every night on the streets of America, you're very vulnerable to all other health challenges that we're talking about. And then, so the question is what role do we play in making sure that our members and our populations around them are basically having the right infrastructures that delivers on what we call total health?”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“So, is the community deprived of normal things that you would expect? Places to go buy groceries, right? And in many of our communities around the country, they are deprived of some of the basics like that. So you don't get the stores that delivers the produce that helps towards better health. And you start to see that being replaced with the kind of fast food restaurants that is really bad for hearts and weight and all those other things. And you start to see that shift. And we now have the kind of collective data where you can see it with obesity and some of the other challenges. If you live in a community where it's unsafe, you find people can find more to the inside of their homes and less likely to be out. And recreations and things like that.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, you know, we have people using terms like social determinants of health. How do you think about community health and all those things? And we have historically played a major role in that. But I would say a couple of things are significantly different now is that, and we used to call it community benefit, and now it's community health. We fully understand now the direct linkage of the community to an individual's health. And we've been at this for a while. And so it starts to play out with our role in assessing the fundamental infrastructure in communities in which we take care of now 12.3 million people.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“Past 27, right? And so when people started living longer, stuff started to happen. Very sophisticated term stuff And we built a hospital, right? Somewhere on earth, there was a hospital built. We moved a lot of people into it and began to take care of them. That basically turned out to be the infrastructure that is still in place today. You now have the big question about what's the definition of healthcare in the 21st century? And I would say it should not be a sick care system because a big part of our knowledge that we've all known, but for sure we know it now, is that a lot of chronic illnesses that people are dealing with are preventable. So, the question is Do we have a new role in healthcare that really focuses on the behavior of people and what that does to the health and well-being and how we manage that in the new paradigm?”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“From Middle Leaves to the third thing, which is, I think the aha for us and the aha, I think in this country that we need to come to terms with is we probably outlived the model that we have in place. I mean, the whole healthcare industry was created, as you know, because a couple of things happened. We figured out how to deal with sanitation and food preparation and all that stuff and people started living longer. And as people started living longer.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“So are they just breathing? Are they functional and people living their lives like they want to live their lives? And with the new medications, new treatment, new way of catching diseases earlier, you now are seeing over time that functionality is much better now than ever before, but have a long way to go when you begin to compare us against some of the other countries who aren't spending nearly as much, but are getting equal, if not in some cases, better outcomes.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“The country, right? So the ACA has gotten a lot of airtime. But the real issue is many Americans who are covered cannot afford the additional cost that's on their backs. Right. Care and they're not covered by the ACA. Some of them are covered by”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“And then you got a market that's behaving in a very different way. Well, if you don't have the government plan the appropriate role to regulate and modulate it in the right way at the right time, then it goes crazy. And then people start moving in and out. So it would be interesting to see what happens over the next several years as we continue to work on that piece of the puzzle. But the bigger issue, by the way, is affordability.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“Healthy people and that kind of thing. Because if I went into the market And it really is going to cost me $1,000 to provide the care. And I'm charging $700 because I want to get the business. And then I take the market and shift it to my direction, and then the next year I lose a lot of money. Then I get out, you've destabilized the entire market. And the law was written in a way to counteract that. And it used to be called a three R's. And so everybody paid into the insurance, for example. So if there were 10 people. And I have three of the ten, and it turns out because of my model, I had the most expensive three. The market will pay me through this reinsurance more because I have the greater risk. So it was a zero-sum game for all the people who competed.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“We all agree how we're going to compete in the marketplace The government, the state government played a critical role in how to convene all of us together. Say we want competition, but we want it done in this way that the citizens of California will be the winners. And so everyone agreed to the guardrails and the guard rules.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“So if you had 20 million people you were projected in the ACA and of the 20 million, about 3 million had pre-existing conditions, you can spread the risk of the 3 million across the entire 20 million. So it was a no brainer that we needed to do that. That's before you talk about the ethical issues of not covering someone. Yes. Who really needs coverage because they get sick, right? And so the law thought through those kinds of things, it was engineered To create a competitive environment where everyone would compete for the members. The best example of it is working fairly well is in California. Where we compete on price, we compete on service, we compete on quality. A bad example is in one of my other states that I won't mention the state. Where you didn't have the guardrails built up front at the state level”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“But if you're an individual, the laws were written years and years and years ago that said if you basically sneeze. The insurer can say you have a resisting condition we can't cover you. Because you had by law to price it to that individual. And many of the companies said, it's not worth it, it would never work all this kind of stuff. And so if you take now a new class of people in a new insurance pool, which is the ACA, you can spread that risk across the entire population.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“So, you take, for example, the issue about pre-existing conditions. I remember when the law was being written, someone came to us and they asked specifically how we felt about this issue of pre-existing condition. And our response was, duh, you need to have it in there. And then the question came back again, and we said, here's the issue. So you take yourself. You can have anything heart disease, cancer, you name it. You're in a group of three or more, you could go to any insurance company around the country and you don't have to worry about your pre-existing condition.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“I just stay away from that, about whose fault it is. I'm just saying that in a country where we must have compromise. Both parties need to be at the table working on it. Ironically, many parts of the Affordable Care Act was actually modeled after a Republican-led law in Massachusetts. In Massachusetts.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“For more people today than before we started. And the whole objective was to target the 30 plus at the time, 30 plus million people who did not have access to the front door of the American health care system So we're better off, right? The second thing is, and it's important in the rollout, the infrastructure of the bill is really good. It was always known that we needed to add regulation to regulate it to achieve the outcomes that it was intended That has never happened because one of the biggest lessons that I've learned in being a participant in the whole structure of the Affordable Care Out, the rollout of the Affordable Care Act is a partisan passed bill for a major change in this country is not a good thing. And so part of the reason why it stalled is because it was approved by one half, the Democrats.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“And those are the most expensive patients. So we did not do very well as a country in the rollout of the ACA. But we're going to have a bigger challenge eventually when we take on the rollout of revised Medicare program.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“Right? By the way, Medicare is the other area that we have to take on in this country. When we did Medicare, it was for people 65 and over. People basically died when they were 65, 66, 66. And so we don't have an infrastructure today for the long term trajectory of how long people are going to be able to live in the future.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“Well, to simplify, this country decided in the 60s that they were going to take care of two people, two classes of people. The elderly and poor people And we solidify that pack in America with two massive legislations, Medicare and Medicaid. So I tell people all the time, don't get caught up in the name of the Affordable Care Act. It's the 21st century version of the Medicaid approach. So, the two major pieces to the ACA really is around the Affordable Care Act, which really was the added definition to Medicaid to say, we have a whole new class of poor called working poor. Is not accommodated in the Medicaid system of 1965. Because the theory of the Medicaid system back in the 60s where people were really poor.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“Well, for us, it's been an evolution. We invested early on in building a comprehensive medical record system. Then we over time continue to upgrade it to add additional features. And so it became for us very functional, clunky at times, but very functional for use for both quality care and also comparing our results across our large system. You take that as the foundation, then you start to build additional technology on top of that. Then you begin to create a new infrastructure in which you can care for a large segment of the populations around the country virtually and in other ways. And so our members love to use the virtual technology because number one, they know the physician and care team has all the data right in front of them. Number two, they know who they are. So there's”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“Well, if you come into the Kaiser Permanente system, you will see that commercial days or something like 150 per thousand. And Medicare is now down to 700. But then what you would look at in terms of the stark difference is I have a whole infrastructure at Kaiser Permanente. We have a whole infrastructure. And so our physicians could have you in the hospital for two days and then you're ready to go home. There's a whole different set of resources that's going to take care of you when you're at home, right? And so it's a whole continuity of care. And so to the member, it feels seamless because you're going from one setting to the other setting. We believe strongly that within the next five to ten years, there's a certain percentage of our admissions into the hospital. We're going to be doing in the homes”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“Yes, we fully embrace technology, but we also scrutinize technology because we look at it from, is it going to enhance quality? Is it going to improve the service experience? What's the cost factors associated with it? And can we produce a better outcome? And because I have the whole dollar and I have to invest in the infrastructure for care because that's embedded in my financing model. Then my incentive is to make the best choice. And so where it really starts to get real, and this is where both my competitors and friendly competitors come in to look at our system, and I'll make the terms very simple. We look at this thing called patient days. And you look at it per given population. And so you hear people say things like we're at 215 commercial days per thousand and we're at 1,300 for Medicare and all that kind of stuff.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“You come in and you look at my model, we invest billions of dollars in testing and prevention for early detection, early diagnoses, early treatment. That's better care upstream to invest, to deal with an issue very early on, then the wait until an issue progress and weakens the body and costs much more to manage and to maintain.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“The right way to characterize it. If you look at the distribution of the healthcare dollars in the industry, number one, the vast majority of the dollars are spent in a couple of areas is spent on chronic care. And is spent on the last thirty to 45 days of a person's life. Right.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“That's right. Or someone really doesn't need to be in the hospital because I have the whole dollar, I've built the infrastructure along the whole continuum. And then our physicians and others can decide the best location. The person should receive care. And the physician is not incented or disincented one way or the other, so they're not making a choice based on the economics. They're making it based on the best interest of the patient and the efficiency of care.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“And the rest of the industry is pretty much still a FIFA service system. It's based on volume and some other ingredients. It's piecemealed and siloed. And so the easiest way to describe it, I get paid the whole dollar to assume the whole responsibility. Many of my competitors get a piece of that dollar, and so they're trying to maximize how much of that dollar can they get. So you take, for example, in my system, we own 39 hospitals. They're not even revenue centers, they're expense centers, right? You go to the rest of the world, the revenue is generated by having what we call a head in the bed. For me, it's no difference with the payment. Sir.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source
“The line of sight for Kesa Permanente is to be a total end-to-end system. And we talk a lot about taking care of people from birth to end of life. We also talk about the fact that our building blocks for our organization is different from the rest of the industry in most cases. We assume total responsibility for the total risk of an individual because our financing system is one in which we get paid a capitated payment for the entire care responsibility of the individual. Secondly, we have all the pieces of the delivery system inside of the four walls of Kaiser Permanente, whether that's Physically there or virtually through the contractual relationship. But in both cases, we still continue to assume the total risk.”
2018-12-21 · a16z Podcast · a16z Podcast: The Infrastructure of Total Health · IDENTIFIED FROM THE TRANSCRIPT · source